A 2-year-old girl with cystic fibrosis is among the masses of Americans who lost Medicaid coverage after the pandemic. The Jacksonville, Fla., toddler needed the insurance to cover life-saving medication and doctor visits, according to a lawsuit filed by the girl’s mother and others. Instead, when he got sick last year, his family settled for a costly emergency room visit.
The crisis described by the Florida family is playing out in communities across the U.S. For millions of Americans, the nation’s pandemic-era expansion of Medicaid health insurance is reaching its the end.
Some turned to options such as an employer insurance plan or the Affordable Care Act. Others survived without insurance, avoided unaffordable doctor visits, and left prescriptions unfilled.
A new survey on the consequences of the resumption of controls on Medicaid eligibility found that nearly 1 in 4 people who dropped out of Medicaid coverage last year are still uninsured. Almost half of the people kicked out of the program eventually reclassified, suggesting they shouldn’t have been kicked out in the first place. And millions suffered gaps in coverage that could have put their health at risk.
The KFF survey found that 23 percent of Medicaid beneficiaries who opted out when states resumed eligibility checks last year still don’t have health insurance. These people are more likely to struggle to pay for health care and delay medical appointments.
KFF, a nonprofit health policy organization, designed the survey to find out how eligibility controls have affected people on Medicaid, the federal health program for low-income and disabled people.
The federal government provided billions of dollars in federal aid to states on the condition that they not withdraw people from Medicaid until the COVID-19 emergency was over. When the public health emergency ended and eligibility checks resumed last April, states were able to conduct these checks on their own. Rhythm. Some states accelerated controls, while others took longer to implement them. Two states, Oregon and Alaska, won’t complete the checks until early 2025.
KFF’s national survey of more than 1,200 American adults found that 19% with Medicaid coverage during the pandemic dropped out temporarily, some for longer periods.
Among people withdrawn from Medicaid, 47% said they eventually re-qualified for Medicaid coverage. More than 1 in 4 adults got health insurance from an employer, the military, an Affordable Care Act insurance plan, or Medicare, the federal health program for people 65 and older .
Even before the pandemic began, people were moving in and out of Medicaid as their life circumstances changed, such as getting hired, losing a job or having a child. What’s unique about the past year is the sheer number of eligibility checks that state Medicaid programs have faced at once in a process known as rollout because the ranks of enrollees swelled during the health emergency public notice of COVID-19.
KFF research shows 20.1 million Medicaid beneficiaries disenrolled since eligibility checks resumed a year ago. Another 43.6 million people had their coverage renewed and 30.4 million are waiting for Medicaid renewals.
Most states should be done with renewals by June, said Jennifer Tolbert, assistant director of KFF’s program on Medicaid and the uninsured. He said the Centers for Medicare and Medicaid Services, the federal agency that oversees Medicaid, is expected to release an estimate of when states will complete those pandemic-era reviews soon.
Tolbert said many people may have been kicked off Medicaid in error. This would explain why so many people who had been removed soon rejoined the public health insurance program. Those dropouts had an impact, he said, because even temporarily losing coverage can hurt people.
The survey found that 56 percent of people who lost Medicaid coverage had skipped or delayed medical care.
“That was a much bigger problem for people who dropped out (which) led to gaps in access to needed care,” Tolbert said.
Dumped on Medicaid, Alabama woman turns to Obamacare
Alabama resident Kayla Wildman, 31, qualified for Medicaid coverage before giving birth to her first child in December 2020. Wildman, who lives in a small town southeast of Huntsville, to say that the insurance was comprehensive and helped her pay for doctor’s appointments, medication and bills for the birth of her second child in 2022.
Last December, in the middle of three months of treatment for hepatitis C, she was dropped from Alabama’s Medicaid program. Without insurance, he knew he couldn’t afford to pay thousands of dollars for medication.
“I was actually freaking out,” Wildman said. “I couldn’t afford to pay full price out of pocket. So I said, ‘What do I do?'”
Before she became pregnant with her first child, Wildman had insurance through her job at a local hospital. Before that, he tried to buy coverage through the Affordable Care Act, known as Obamacare, but the plans cost too much.
She tried again when she lost Medicaid last November and bought a Blue Cross Blue Shield plan through the ACA marketplace for $65 a month. The KFF survey found that 8 percent of people like Wildman, who were dropped from Medicaid, got a new plan through the ACA, thanks in part to more generous pandemic-era subsidies that they make monthly premiums more affordable.
The insurance plan paid for her hepatitis C treatment and she is now cured of the viral disease.
You also have a wider selection of doctors compared to your options under Medicaid.
“It’s not so unaffordable that I can’t handle it,” he said.
Consumer advocates challenge Medicaid cuts
Consumer advocates say many people have lost Medicaid coverage because of paperwork errors and other administrative errors. The Medicaid renewals are perhaps the biggest bureaucratic effort at government health insurance coverage since the Affordable Care Act launched state Medicaid expansions more than a decade ago.
Advocates say consumers have faced long wait times when seeking help from state Medicaid programs. Other patients, including some people with disabilities, have had trouble getting help in person, said Alicia Emanuel, a senior staff attorney at the National Health Law Program in Los Angeles.
People on Medicaid have always faced these challenges, but the pandemic backlog of renewals compounded the problems, Emanuel said.
“These problems are illustrative of the cracks in the Medicaid system,” Emanuel said. “These are issues that advocates have been sounding the alarm about for years. A tipping point has been reached because of the unfolding.”
Attorneys representing Medicaid enrollees in Tennessee and Florida have sued to challenge their states for denying coverage to adults and children. Both lawsuits are pending.
The Florida class action lawsuit was filed by two mothers of two young children who said the state failed to provide their families with adequate written notification before ending their coverage.
KFF’s Tolbert said disruptions in care are inevitable when such a large number of people across the country have to renew coverage. In many cases, people who get coverage through an employer or the ACA marketplace find that they are expected to pay a larger share of their health bills through deductibles and coinsurance.
“Many people switching from Medicaid to other coverage are expressing concerns about their ability to pay for the cost of care with their new insurance,” Tolbert said.
Ken Alltucker is at X at@kalltucker, contact him by email at alltuck@usatoday.com.
#States #cut #Medicaid #enrollees #added #COVID19
Image Source : www.usatoday.com